The pararectus approach-a versatile option in pelvic musculoskeletal tumor surgery.

Kurze, Christophe; Keel, Marius Johann Baptist; Kollár, Attila; Siebenrock, Klaus-Arno; Klenke, Frank Michael (2019). The pararectus approach-a versatile option in pelvic musculoskeletal tumor surgery. Journal of orthopaedic surgery and research, 14(1), p. 232. BioMed Central 10.1186/s13018-019-1275-x

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BACKGROUND Pelvic tumors are usually resected through the utilitarian pelvic incision, an extended ilioinguinal/iliofemoral approach. The pararectus approach, an intrapelvic anatomical approach with extraperitoneal access to the pelvis, has been established previously for the treatment of pelvic and acetabular fractures. However, it has not been used to address pelvic tumors. The study aimed at investigating the feasibility of this approach for pelvic tumor surgery and the possibilities of combining this approach with standard approaches to the hip joint. METHODS Thirteen patients that underwent pelvic tumor resections were retrospectively reviewed. Tumor resections were performed through the pararectus (n = 10) or extended pararectus approach (n = 3). In six of those cases, the pararectus approach was combined with extrapelvic approaches including the modified Gibson (n = 4), the Kocher-Langenbeck (n = 1), and the trochanteric flip approach (n = 1). The mean follow-up was 32.6 ± 9.1 months. RESULTS In all cases, the tumor resections were carried out according to the preoperative plan. In seven of 13 cases, wide resections were performed; six of 13 cases were planned close resections. Four cases of major complications were observed (vascular injury, deep infection, iliac vein thrombosis, total hip arthroplasty dislocation). Minor complications were observed in two cases. One tumor recurred locally. At the final follow-up, 10 patients were alive, eight of those without evidence of disease. CONCLUSION The study demonstrated the suitability of the pararectus approach for pelvic tumor resections. The possibility to combine the approach with standard approaches to the hip joint allowed for single-stage reconstructions of the pelvis and the hip joint without sacrificing surgical margins and function. The pararectus approach is a versatile option adding to the established approaches for musculoskeletal tumor surgery of the pelvis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Kurze, Christophe; Keel, Marius; Kollár, Attila; Siebenrock, Klaus-Arno and Klenke, Frank M.

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1749-799X

Publisher:

BioMed Central

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

24 Oct 2019 16:25

Last Modified:

31 Oct 2019 10:26

Publisher DOI:

10.1186/s13018-019-1275-x

PubMed ID:

31337419

Uncontrolled Keywords:

Complications Pararectus approach Pelvic tumor Resection Sarcoma

BORIS DOI:

10.7892/boris.134127

URI:

https://boris.unibe.ch/id/eprint/134127

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